BACKGROUND
Cardiovascular health (CVH) is increasingly recognized as an important modifiable factor for reducing risk of Alzheimer’s disease and related dementias (ADRD). The American Heart Association’s Life’s Essential 8 (LE8) integrates behavioral and clinical metrics to assess overall CVH.1 Our previous work found that higher LE8 is associated with reduced cerebrovascular disease burden, lower odds of infarcts and white matter hyperintensity (WMH) burden, and greater total and frontal gray volumes 10 years later.2 Additionally, our work has also suggested that plasma ADRD biomarkers are associated with subjective cognitive decline and objective cognitive performance.3,4 Whether better CVH is associated with a more favorable profile of plasma ADRD biomarkers remains unclear, particularly among Hispanic/Latino adults, a population disproportionately affected by cardiovascular disease risk factors and dementia.
OBJECTIVE: To determine whether cardiovascular health, assessed using LE8, is prospectively associated with plasma ADRD biomarkers among middle-aged and older Hispanic/Latino adults 6 years later.
METHOD
Study Population: Study of Latinos–Investigation of Neurocognitive Aging (SOL-INCA; Unweighted analytic sample: n = 5,439), an ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Exposure: Life’s Essential 8 (LE8) measured at HCHS/SOL Visit 1 (2008–2011; Range: 0–100 points).
Outcomes: Plasma ADRD biomarkers measured approximately six years later (2014–2017) using Simoa (Quanterix HD-X), incuding Aβ42/40, pTau-181, pTau-181/Aβ42 ratio, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP).
Statistical Analysis
Survey-weighted linear regression estimated associations between baseline LE8 scores and plasma ADRD biomarkers measured approximately 6 years later. Biomarkers were natural log-transformed to improve normality. b coefficients represent the expected difference in biomarker concentration associated with a 10-point higher LE8 score. Model 1 (M1): unadjusted, Model 2 (M2): adjusted for age, age², sex, Model 3 (M3): additionally adjusted for Hispanic/Latino background, education, income, language preference, and field center.
RESULTS
Higher baseline LE8 scores were associated with higher Aβ42/40 (b: 0.01, 95% CI: 0.01,0.02), lower pTau-181 (b: -0.02, 95% CI: -0.04,-0.01), lower NfL (b: -0.03, 95% CI: -0.05,-0.01), and higher GFAP (b: 0.03, 95% CI: 0.02,0.04) six years later. Associations with pTau-181/Aβ42 were attenuated after adjustment.
DISCUSSION
Better cardiovascular health was associated with higher Aβ42/40 and higher GFAP, lower pTau-181 and lower NfL, suggesting cardiovascular health may influence the circulating levels of these ADRD biomarkers. This extends prior findings showing that (1) higher LE8 is associated with lower cerebrovascular disease burden and greater gray matter volumes.2 and (2) pTau-181 and NfL are associated with poorer global cognitive performance in this population.3 Circulating biomarker concentrations may be influenced by blood volume independent of underlying neuropathology.5 Additional studies are needed to determine whether CVH and brain health associations are mediated by plasma biomarkers. Limitations: additional confounders (e.g. kidney function).
Conclusion
Better cardiovascular health in midlife and older adulthood was associated with a more favorable plasma ADRD biomarker profile approximately six years later. Findings support cardiovascular health optimization as a promising strategy for ADRD prevention among Hispanic/Latino adults.
References:
1.Lloyd-Jones DM, et al. Circulation. 2022;146(5):e18-e43.
2.Márquez F, et al. Alzheimers Dement. 2026;18:e70372.
3.Márquez F, et al. Commun Med (Lond). 2025;6:33.
4. Márquez F, et al. JAMA Netw Open. 2025;8(9):e2531038.
5. Jacobs T, et al. Alzheimers Dement. 2025;21(10):e70765.
